The Twilight

Sexual behavior of the elderly especially the ‘Human Female’ of the menopausal age group is relatively a new subject to be talked about. The society looks down upon desire and libido in  these women. Even elderly men are castigated for their sexual drives. Menopause is the most misunderstood biological change that happens to a woman; a change that can be both traumatic and psychologically challenging. Yet every woman’s reaction to menopause is different. Cultural and social attitudes influence women’s behaviour and ultimate outcome. Most women are not very well informed about menopause, and myths such as menopause being a ‘disease’ rather than a natural phenomenon are readily believed. Lack of awareness, busy working hours, poverty, gender bias, discussion of sexuality still a taboo plus the apathy of society further aggravates the condition. Tripti, a Delhi-based gynaecologist, unveils the various myths and strange beliefs about menopause, in this fictionalised account of real life incidents, exclusively for Different Truths.

Something was bothering her. I knew the minute she entered my chamber. A little reluctant to speak, she kept shifting on her chair while her eyes kept darting to the door.

“Do you want your husband to come inside?” I spoke gently

“No please. I would rather he stayed outside.”

From where I sat I could see him clearly. An elderly gentleman, he peered suspiciously through his thick rimmed glasses. He looked otherwise quite smart in his dungarees.

And so was this elderly woman who was fidgeting with a piece of paper lying on my table.

“You have children?”

“Yeah, two. Both settled in USA. I have just come back from visiting them.”

With no gynae complains either, a sixty two year old woman, looking apparently healthy though a little fragile,was yet to tell me what brought her to my clinic.

I looked at her inquiringly.

“Actually, my husband!” She hesitated, then stopped abruptly as if too embarrassed to continue.

“It’s Okay, please go ahead.”

“My husband is still entrapped with carnal pleasures. Even though I want to go along with him, my body betrays me. I am no longer young and it is too difficult for me to be a proper wife to him in the true sense.”

“You still have to prove to him that you are a proper wife?” I couldn’t help this.

“No doctor, you don’t understand. I hurt so much and my husband is getting frustrated. It’s embarrassing but what should I do?” She sounded miserable.

“He has been pushing me to see a doctor but I….” Her voice trailed off. She looked around helplessly.

The repeated attempts to be a ‘proper wife to’ her husband had left a trail of painful bruises on her now dry and constricted vagina. Aging had brought in some degenerative changes and she would need corrective surgery to restore her anatomy.

“But what do I tell my children?”

It was obvious she couldn’t tell them the real reason.

“It’s so demeaning at this age. Somehow, I have also lost the inclination. But my husband is another matter.”

Some stereotypes we suffer from. Age was supposed to be just a number! But then was it?

“At this age one is supposed to go Vanprasth, giving up on all attachments. That’s what our scriptures have taught us, isn’t it?” She made a feeble attempt to smile.

I seriously wondered about that.

“Our religion also teaches us that the spirit is immortal, it never dies. How can age break something that even death cannot touch upon? It’s the body that grows old, not the mind.” I countered philosophically

Confusion still clouded her eyes and she looked back uncertainly.

“You cannot be responsible for what other’s think. But if it embarrasses you, you can choose not to tell anyone.”

Relief dawned in her crinkling eyes. She left, promising to be back once they had discussed at home.

Her husband with a confident lift of his shoulders nodded at her as she came out of the clinic.

I looked at them with sympathy. Sexual behavior of the ‘Human Female’ especially of the menopausal age group was relatively a new subject to be talked about. Social taboos did not allow these women to know the difference between normal / physiological sexuality and sexual dysfunction. Due to lack of knowledge many couples were suffering in silence.

Moreover, we were a country where there was an age for everything. Clothes, hairstyle, makeup, jewellery, food and to an extent lifestyle too, came with a tagline, ‘unsuitable for those above 60’. Did the right to fall in love, to desire or be desired, also come with an expiry date? Was it only for the young to enjoy and experiment?

“We have lived our age. Now it’s your turn.” A familiar line from the senior generation but did that indirectly mean that they should stop living! After crossing that nefarious line of no return, was one supposed to grow more puritan and religious in thoughts as well as deed, else simply wait for the ultimate union with the divine. And if some errant desire raised its ugly head, did it have to be crushed straight away? What a hypocritical society we lived in?

The elderly women were the most vulnerable, especially in a developing country where all the existing resources were overburdened with problems of women of childbearing age. As a result it hardly addressed the specific health of older women. They were often neglected, their needs ignored by the public health systems, their families and sadly by the women themselves.

I once saw a woman of seventy with third degree prolapse uterus. She had been suffering from the distressful condition for the last fifteen years.

“Why didn’t you come earlier? The results of the surgery would also have been better.” I dreaded imagining how she was sitting on the chair or attending to basic routine like emptying her bladder and bowel. The loss of quality of life was beyond comprehension.

“I am sorry, doctor. However, what is now left of me? Fifteen years back my husband passed away. I had to bring up my kids alone. Their marriages, the subsequent birth of my grandchildren and later their studies, my duties always took precedence. My daughter-in- laws were all working. How could I be selfish enough to abandon all and get operated?” Her life was no less of tapasya. Was this what our Vedas called as ‘the vanprasth ashram’?

“Didn’t your children ever ask you to see a doctor?”

“They often did especially when I had menopause. Life had become a little painful with those hot flushes and recurrent burning and infections. But then it settled down on its own. I couldn’t somehow make myself a priority.” She laughed brokenly. Unfortunately nobody else thought of making her a priority.

I had seen patients who suffered urinary incontinence for long many years before finally coming to a doctor with something akin to  shame written all over the their faces. With age many women lost control over the urinary bladder. This was something that could be treated medically as well as surgically with good results. Yet they chose to endure, the bad stench of urine forcing them to withdraw quietly. The hesitation in taking a medical opinion baffled me.

No wonder we had so many cancers these days, just because we failed to detect them at the precancerous stage. Most of the symptoms were ignored under the garb of ‘normal process of aging’. The menopause was a period of ‘compressing morbidity’. This was a window of opportunity to identify diseases at an early stage and reduce the morbidities later on in life. But even educated women believed that ill-health was a part of menopause and sadly very few came for regular check-ups.

A fitness enthusiast, I especially advocated exercises to the elderly women. Maintaining body’s equilibrium as they grew older and also building bone strength through weight training was as important to them as it was for those young guys sweating out for six packs. But one of them, encouraged by me to join a gym, sat dejected in my clinic one day.

“The gym instructor looked almost funny. He told me categorically that they would not take women above sixty. This was after I had mustered enough courage to go to the gym. Even my grand-children pass me indulgent glances these days.” I seethed at the implied insult.

Even medical professionals sometimes suffered the same prejudices as the rest of the society.

A woman of fifty, who wanted contraceptive advice, was given queer looks.

Another one, around fifty, was going to have her uterus removed due to fibroids. The couple were much concerned about their sexual life being hit by that. Though the fallout of the surgery on their bones and other vital organs had been emphasised, their priority refused to shift. Despite reassurances, they repeatedly asked the same question to all and sundry, making people uncomfortable and look the other way. On a much younger couple, the staff would have been definitely more understanding and sympathetic.

A similar patient did not adhere to the postoperative advice for abstinence and reported to the casualty bleeding profusely from the vaginal vault. Very unbecoming for their age! Embarrassed by the disapproval in the eyes of the hospital people the couple took to denial despite the initial admission of their ‘guilt’.

Once, a widow of around fifty five, came with lot of vague symptoms. It was soon evident she was feeling lonely. Having lost her husband at a young age, she had managed to stay afloat for lot many years, dependent on her children. But now with both of them married, emptiness was killing her. She now craved for company. An attractive woman, she started looking for a partner. However, it was extremely difficult to find one. Her close relatives ridiculed her and didn’t understand why she wanted to have a relationship at this age? Strangely her daughter’s supported her. Their only concern was their mother’s happiness. It was no coincidence that the daughters lived in the US of A. This was no hidden truth. We were more orthodox in our thoughts than the liberal west. They valued the needs of people and respected their privacy more than us. And they were never rude enough to relate everything with ‘age’.

It was not the culture but the faulty interpretation of culture that had brought a bad name to us. Celibacy was never celebrated in Hinduism. No puja or Yajna was complete without a partner. And majority gods were not worshipped without a goddess. Yet the guardians of our culture propagated myths.

If it was tough on women, it was not easy for men either. We were still a society that frowned upon the sexual needs of the senior citizens. Suppressed desires had sinister retributions. Not only adolescents, even people above seventy were taking recourse to the virtual space. Most of them were filling in the void created by the loss of their life partners.

A close family friend rang me up few days back, “I am fed up with my father. From a loving father and a doting grandfather, he is suddenly behaving so oddly. He is all the time either reading erotic stuff or watching dirty movies on the internet. He even keeps staring at young girls. I am too scared to have him alone with the domestic helps. I stand to lose everything if he does something really stupid.”

“Your father had faith in you when you were growing up. Why don’t you trust him now?”

“That was different. I was young but look at his age. I can’t even talk to anyone about this. Please suggest me a doctor.”

She had already declared him a psychological case, some kind of amoral character on loose who had to be treated. A desire that was celebrated in the youth had turned to pathology in the waning years? Needless to say the poor man was subjected to a battery of test to prove that he was normal.

Not surprisingly in movies an old man lusting after young women was shown as comical. There was this movie Namkeen where three old men, trying hard to control their libidos, were either leering at buxom beauties or planning rendezvous with sexy lasses. Predictably, the movies was labelled a comedy.

Agreed that one should age gracefully and normally, but a very old civilisation we still struggled with what constituted ‘normal’. Some feelings were supposed to ebb away as we moved into the twilight and merged with eternity. But ‘nature’ and ‘culture’ often contradicted each other.

An old couple was slowly moving towards the shore. Their hands intertwined, the husband guided his frail wife, who limped slowly behind him to a lonely bench. They made a beautiful pair as they silhouetted against the fading horizon. A young couple walked leisurely on the sandy beach, digging their feet in the sand and splashing it on each other’s face playfully. The older couple watched and a reminiscent smile lit up the crisscross on their faces.

Life was a celebration and what better than love to spice it up with.The beautiful twilight that enchanted us before sunrise, tempted us at sunset as well. Nature taught so effortlessly what culture imposed, yet failed to reach out.

A tired sun broke through the grey seams. The rays teased, lingering over the waves as they rose high to meet them, flirting a little before the waves ebbed away. Yes, it was twilight once again!

Note: Menopause is the most misunderstood biological change that happens to a woman; a change that can be both traumatic and psychologically challenging. According to IMS research, there are currently 65 million Indian women over the age of 45.By 2025, more than 12% of population will be more than 60 years. Almost 50% of these will be women.

©Tripti Sharan

Pix from Net.

author avatar
Dr. Tripti Sharan
Tripti is a practising gynaecologist at BLK Super Speciality Hospital, New Delhi. Many of her writings are influenced by the pain and suffering she sees as a doctor. Her forthcoming book ‘The Chronicles of a Gynaecologist’ is being published by Bloomsbury India. She also has an anthology of poems,‘The Dewdrops..a journey begins’. She contributes poems and stories to many publications.

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